Select Committee on Health Minutes of Evidence

Letter from the Parliamentary Clerk, Department of Health, to the Clerk of the Committee


  This letter sets out the Department's response about the additional information we agreed to provide at the hearings for this year's PEI.

1.  Nursing care—patients' right of appeal against assessment of eligibility

  We envisage that patients will have the right to appeal against an assessment under arrangements similar to those set out in the guidance Discharge from NHS Inpatient Care of People with Continuing Health or Social Care Needs: Arrangements for Reviewing Decisions on Eligibility for NHS Continuing Inpatient Care. (HSG (95) 39/LAC (95) 17). The arrangements will be set out next year in guidance to the NHS and local authorities on free nursing care.

  The review procedure will be an additional safeguard for patients who believe they require registered nursing care in a nursing home and who consider that the assessment and/or application of eligibility criteria have not been correctly carried out in their case. It will apply to all patients who have been receiving NHS inpatient care, whether in a hospital, or arranged and funded by the NHS in a hospice, nursing home, or elsewhere, and to all client groups covered in local eligibility criteria.

  The procedure will affect patients' rights under existing NHS and local authority complaints procedures. NHS Complaints Procedure encourages local resolution whenever possible, if necessary by referral to a local "convenor".

2.  Data on GP waiting times

  Table 1, attached at Annex A, shows results from the National Survey of NHS Patients, which was published in October 1999. The survey only gives information on waiting times to see a GP—there is no information held centrally on the waiting times to see a nurse.

  Care, however, should be taken when using the data contained in table 1, as it could be an overestimate of waiting time to see a GP because it relates specifically to the GP of choice rather than another available GP within the practice. Full results (At HA level) from this survey are available on the internet at

3.  Data on the numbers of new intermediate care beds, broken down into NHS provided and independent sector provided beds

  This information is not currently available.

4.  Clarification on the reduction in geriatric bed numbers (as shown in Bed Availability and Occupancy 2000—Table 4.13.1 of the Report)

  The NHS Plan highlights the Government's wish to build a bridge between hospital and home by developing a wide range of intermediate care services to prevent avoidable admissions, provide rehabilitation and enable as many people as possible to maintain or regain independence in their own homes. This will be done partly by investing more in NHS services, including giving new life to community hospitals, and partly also by entering into new partnerships with the independent sector.

  In the Plan, it was stated that there will be:

    —  7,000 extra NHS beds by 2004;

    —  of these around 2,100 extra beds will be in general and acute wards—the first increase of its kind in 30 years;

    —  5,000 extra NHS funded intermediate care beds, some in community or cottage hospitals, others in specially designated wards in acute hospitals. Some will be in purpose built new facilities or in redesigned private nursing homes;

    —  1,700 extra non-residential intermediate care places;

    —  a 30 per cent increase in adult critical care beds over the next three years as a result of resources allocated this year and to follow over the next three years.

  These increases in beds and places, especially for older people, should help improve bed availability in hospitals.

5.  Information on the percentage of people in residential nursing homes who (i) have all or most of their nursing and personal care costs paid for; and (ii) of these the proportion of patients who have sold their homes since being in care

  The Department does not hold information on the number of people whose fees are paid for by the state but have exhausted their funds through selling their home since being in care.

  However, the 1996 PSS Research Unit survey of residential care provides some relevant information. The information relates to permanent publicly funded residents aged 65 and over in independent sector homes. Eleven per cent of the stock of elderly permanent local authority supported residents had been self-funding on admission. The equivalent figure for DSS funded preserved rights residents was 23 per cent. These figures need to be treated with caution as information on source of finance at admission was missing for around 25 per cent of publicly funded elderly residents.

6.  Supplementary questions on inflation

  Responses to these two additional questions are attached at Annex B.

  I will be writing to you separately on the questions relating to PFI and EU healthcare spend.

  Finally, I would like to apologise for the time it has taken for the Department to respond to the points raised by the Committee members.

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